“HMR is responsive, diligent, and supportive and I have always been able to get the full billed amounts in front of the jury because of HMR’s back-end support. Beware of fly by night lenders and small unproven factoring outfits. If your client is uninsured and needs care call HMR, you won’t regret it.”

— Jesse, California Personal Injury Attorney

We are a passionate team of professionals who provide personal injury funding for uninsured and underinsured personal injury victims.

Aligning With You

At HMR Funding, our personal injury funding programs are designed to alleviate the financial concerns of your clients who lack the resources to access quality healthcare and sometimes even provide for their family’s basic need of food and shelter.

We align ourselves with leading attorneys, making our broad range of services available to your clients – allowing you to focus on achieving the most favorable case outcomes.

Sharing the Risk

As a contingency fee attorney, you may have to advance the cost for court filings, research, experts, discovery and the general overhead associated with the preparation of the case and do not receive your payment until the case is won or settled.

We are similar in that we only receive our payment when the case is won or settled. We take the risk alongside you and never interfere or question your management of the case. Our services are provided at no cost to your firm.

Comprehensive Underwriting and Expedited Response Time

Our team of skilled underwriters can complete most case applications quickly after the application’s submission. We respond promptly and professionally.

Help your clients receive medical treatment

No cost and no risk to your firm | We work with a nationwide network of providers or your plaintiff may be able to use their existing providers

“I think HMR Funding saved my client’s life. I know it had a huge part in saving my case.”

— John, Missouri Personal Injury Attorney

START THE APPLICATION PROCESS TODAY

1Plaintiff Info

2Plaintiff Attorney Info

3Case Status

4Defendant Liability

5Injuries

6Insurance Review

7Additional Info

8Checklist

9Description

SECTION 1: Plaintiff Information - GENERAL

Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZIP Code

Email

Mobile Phone

Date of Birth*

MM

DD

YYYY

Driver's License #

Medical expenses to date

Display a downloadable PDF Preview?

Yes

No

PDF Preview

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

SECTION 2: Plaintiff Attorney Information

Working with HMR?

Are you working with an HMR representative?*

Name of HMR representative:*

Display a downloadable PDF Preview?

Yes

No

PDF Preview

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Has any doctor indicated (by way of medical record or written narrative) that the injury that needs medical procedure is due to this incident (as opposed to a pre-existing condition).

Please attach medical records.

accepted file types: jpg, gif, png, pdf

Drop files here or

Are there any concerns that the injury is an aggravation of a pre-existing condition?

Please explain:

Has Plaintiff had PAST medical conditions on same body area?

What year?

Please explain:

Has Plaintiff had SUBSEQUENT medical conditions on same body area?

What year?

Please explain:

Please provide any additional insight into the causation of the injuries.

Display a downloadable PDF Preview?

Yes

No

PDF Preview

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

ACKNOWLEDGEMENT - RELEASE OF MEDICAL RECORDS
In connection with this case, certain medical records (“Medical Records”) related to Patient will be created, including without limitation, images, physician notes, lab reports, invoices and bills. The Medical Records constitute the Protected Health Information (as such term is defined in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the regulations promulgated thereunder) of Patient. The Patient has authorized this firm to release the Medical Records to HMR Funding, LLC and its affiliates and those providers HMR Funding, LLC or its affiliates may be contracting with, or considering to contract with, as the payor of medical services on behalf of the patient. The authority of Patient’s attorney under this Release will terminate upon termination of such attorney’s representation of Patient. The authority under this Release will terminate upon Medical Provider’s receipt of payment in full for all amounts owed to Medical Provider in connection with the Services. Patient may, in its sole discretion, revoke this Release at any time, by
providing written notice to this firm.

LETTER RELATED TO ASSIGNMENT AGREEMENT
This Letter Agreement is delivered by the attorney of the Patient (as defined above) to HMR Funding, LLC and its Affiliates (“Assignee”) in connection with separate Assignment Agreement(s) (each, an “Assignment”) by and between Patient and certain medical providers (each a “Medical Provider”) that provide medical services to Patient in connection with the incident (“Incident”) that occurred on the Incident Date identified above. As the Patient’s attorney, we acknowledge that Patient has or will irrevocably assign the Proceeds (as such term is defined below and up to the amount (“Expense Amount”) indicated on the corresponding billing statement(s) provided by the applicable Medical provider) to the applicable Medical Provider, and that such Medical Provider then assigned the Proceeds up to the Expense Amount to Assignee, and we agree, to the best of our ability, to honor such assignments, including without limitation by causing the full Expense Amount to be paid to Assignee if and promptly after we receive corresponding Proceeds. The term “Proceeds” means proceeds recovered on Patient’s behalf that arise out of any litigation, judgment, verdict, settlement, arbitration or mediation, or any other collection activities related to Patient’s pending or subsequent claim(s) and/or action(s) related to the Incident. In the event we recover Proceeds on behalf of Patient, we agree to (a) withhold from such Proceeds, after deduction of attorneys’ fees and costs, all amounts necessary to pay the Expense Amounts, as such amount is communicated by the applicable Medical Provider to us and/or Patient; and (b) promptly remit to Assignee (at the address set forth above), the portion of such Proceeds necessary to cover the Expense Amounts.

SUMMARY*

To the best of my knowledge, the information contained in this application is true and is an accurate summary of this case.
By my signature below, I/We hereby certify that this signature is on behalf of the Firm and Attorney in Charge.

ATTORNEY SIGNATURE

Attorney Name*

TitleFirstLast

Confirmation Email*

HMR will send a copy of your submission to this email address.

Display a downloadable PDF Preview?

Yes

No

PDF Preview

Your information will display below upon entry. You can download the PDF preview of your form at any time. Simply click on the download icon in the top right-hand corner of the preview. TO AVOID RE-KEYING YOUR ENTRIES, BE SURE TO CLICK 'SAVE AND CONTINUE' BUTTON AFTER DOWNLOADING YOUR PREVIEW.

FREQUENTLY ASKED QUESTIONS

Our personal injury funding is an ideal solution on those cases where your client does not have health insurance or if their health insurance plan has high deductibles and severe co-pays that your client simply cannot afford to pay.

We consider personal injury, premises liability, product liability, medical malpractice, maritime, offshore, and many other types of cases/claims. We often provide funding to pay for the physician, hospital or ambulatory surgery center, anesthesia, and other ancillary services from basic cases to the most complex surgical cases.

Yes, our medical funding solutions have been specifically developed to help uninsured victims access quality health care. HMRF will review your case and, once accepted, we will purchase your client’s medical bills while your client focuses on their recovery. Your client pays HMRF at the end of the case only if there is a recovery.

Yes, we actually have two medical funding solutions for your client. If your client elects to use their insurance, we may be able to advance your client the money to help cover the deductible and co-pays associated with their medical treatment. If your client elects not to use their insurance, HMRF may pay the medical providers directly.

Yes, we are your personal injury funding solution. Once your case is approved, we can provide money to your client to help with their ordinary living expenses such as rent, utilities, car payment, food and other expenses they may have month to month while you concentrate on achieving the best case outcome possible.

Our professional staff has many years of experience working with leading personal injury attorneys and paralegals across the country. Our role is to be your “go to” resource to help your firm access the most talented medical providers for your clients. We will take significant work off of your paralegals simply by doing what we do every day.